People Francesca Colombo

The Pandemic of the Future Could Be Silent

, by Camillo Papini
It's time to choose in which direction national health systems should go. The future is not rosy and we need imagination to rethink it, says Francesca Colombo, alumna and head of the Health Division of the OECD. A future where the development of AI could help, but which could also see the arrival of new types of health emergencies

There was Covid and there will be other health emergencies, perhaps less serious but probably more frequent. Added to this are economic and geopolitical crises, which drain resources from government budgets, while a balance still needs to be found in introducing new digital technologies in the management of national health systems. This is why today the Italian and international health care sectors find themselves at a turning point: «We need to understand which fundamental services we must concentrate our resources in the near future, considering a global context in which, above all, the population tends to increasingly age, the demand for quality health services grows, and the contribution of technology, which is certainly positive, however entails greater costs", states Francesca Colombo, head of the Health Division of OECD, the organization that brings together 27 of the world's advanced economies and has among its objectives precisely the rethinking of current economic models that are experiencing stress or difficulty.
Overall, therefore, the public budgets of OECD countries recorded an average health care outlay equal to 15.5% of total public expenditure in 2021, up compared to 14% in 2011, with the particular case of Italy going against the trend with 12.4% in 2021 down from 13.2% in 2011. In 2022, health care costs accounted for 9.2% of GDP on average in OECD countries, and 9% in Italy, again according to OECD data.

«The post-Covid spending trend sees on the one hand a contraction as a consequence of the return to normality», underlines Colombo, who graduated in Economics and Management from Bocconi University, «but also new costs and further expenses that end up having an impact, such as those dictated by international conflicts that divert available financial resources. For these reasons, it is time to choose which direction health care should take, which path society itself wants to take about health systems. The future is not rosy and imagination is needed to rethink health care and maximize its benefits."
However, «the prospect is to guarantee better performing services to a population that has better life prospects than in the past and more personalized assistance, so-called precision medicine, in a sector where private provision of health can be a complement to the public one, as long as it does not create inequalities in access to services, their quality and the quality of assistance of medical personnel, whose homogeneous presence on the territory is another important challenge", says the OECD official. «However, the question mark remains on whether, for example by aiming for greater customization, we risk losing economies of scale, and, despite preventive cost-benefit evaluation, new technologies could lead to a growth in costs that casts doubt on their net benefits."

In short, we foresee an evolving scenario in which AI is introduced and, if it is well managed according to responsible and ethical use, could bring important benefits. Just a few examples include the optimization of clinical procedures, the acceleration of research and development, greater accuracy of diagnoses, without forgetting the reduction of duplication and waste.
What types of more frequent health crises should we get used to? «The hope is they won't be as serious as Covid», concludes Colombo, «but the next emergencies will not be triggered exclusively by pathogenic elements but also, for example, by resistance to antibiotics, the so-called silent pandemic, or to climate change which, among other things, causes peaks in temperatures that are hazardous for various segments of the population."

Francesca Colombo became head of the Health Division of OECD (Organization for Economic Co-operation and Development), after graduating in Economics and Management from Bocconi University and specializing in Development Studies at the London School of Economics and Political Science.